Healthcare Provider Details

I. General information

NPI: 1922479401
Provider Name (Legal Business Name): HOVLAND HEALTHCARE PRODUCTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2015
Last Update Date: 05/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24864 TRI LAKES DR
PELICAN RAPIDS MN
56572-7555
US

IV. Provider business mailing address

24864 TRI LAKES DR
PELICAN RAPIDS MN
56572-7555
US

V. Phone/Fax

Practice location:
  • Phone: 701-388-9731
  • Fax: 218-585-7305
Mailing address:
  • Phone: 701-388-9731
  • Fax: 218-585-7305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number104222
License Number StateMN

VIII. Authorized Official

Name: TORREY LEE HOVLAND
Title or Position: OWNER
Credential: OTR/L
Phone: 701-388-9731